Does Myfembree Shrink Fibroids?

Heavy menstrual bleeding is a common problem, affecting roughly 1 out of every 5 American women. There are multiple causes for this, but one possible explanation is uterine fibroids.

Uterine fibroids — often referred to as fibroids — are non-cancerous tumors that grow in or around the uterus. Besides heavy bleeding, fibroids can also cause lower back pain, a feeling of fullness around your hips and genitals, and problems during pregnancy.

There are multiple ways to treat heavy bleeding due to fibroids. Myfembree (relugolix / estradiol / norethindrone acetate) is an oral medication option. This once-daily pill can effectively help lighten bleeding and reduce pain. So, it may be a convenient option compared with other treatments. But, it’s important to know that while it’s effective, Myfembree doesn’t shrink fibroids.

What is Myfembree?

Myfembree is a combination of three medications: relugolix, estradiol, and norethindrone acetate. It comes available as a once-daily oral tablet that you can take with or without food. Besides treating heavy bleeding due to fibroids, Myfembree is also FDA-approved to help reduce pain due to endometriosis.

You should begin your first Myfembree prescription within 7 days after the start of your menstrual period. Once you start taking it, continue taking it every day until your healthcare provider tells you to stop.

You shouldn’t take Myfembree at the same time as hormonal birth control. These types of birth control can raise your risk of side effects while also taking Myfembree. Hormonal birth control can also make Myfembree less effective. Discuss non-hormonal birth control options with your provider.

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Does Myfembree shrink fibroids?

No. Myfembree doesn’t shrink fibroids. Researchers measured changes with many symptoms of this condition. These included fibroid size. They compared people taking Myfembree with people taking a placebo (a pill with no medication in it). After 24 weeks (about 5.5 months), there were no significant changes in the size of fibroids in the Myfembree group.

How does Myfembree work for fibroids?

The three medications in each tablet all have different roles when it comes to how Myfembree works. But the relugolix component is what’s responsible for lightening menstrual bleeding and reducing pain.

Relugolix belongs to a group of medications called gonadotropin-releasing hormone (GnRH) antagonists. It attaches to an area of your brain that signals the body to produce estrogen and progesterone — the two main hormones responsible for your menstrual cycle. Once relugolix starts working, your body produces less of these hormones, and you experience less bleeding and pain.

Estradiol is a synthetic (lab-made) estrogen. While it may seem like taking an estrogen along with relugolix would cause the opposite effects, estradiol actually plays an important role. Because relugolix lowers your natural estrogen levels, you’re at a higher risk for bone loss (more details on that later). Estradiol helps prevent that side effect by providing your body with some of the estrogen it needs to keep your bones healthy.

Norethindrone acetate is a type of progestin — synthetic progesterone. Again, taking a progestin may seem like it would counteract relugolix’s effects, but it doesn’t. If you have a uterus and take a form of estrogen, such as estradiol, it’s important to also take a progestin. Taking estrogen by itself raises your risk of developing endometrial (uterine) cancer, and progestins help lower that risk.

How effective is Myfembree for fibroids?

Myfembree seems to be quite effective for lightening menstrual bleeding and reducing pain or discomfort due to fibroids.

In clinical trials, Myfembree helped relieve heavy bleeding for over 70% of participants who took it. On average, people reported 84% less bleeding while taking Myfembree. In fact, about 50% of participants taking the medication stopped getting their periods altogether. What’s more, about 43% to 47% of those who had moderate to severe fibroid pain experienced little to no pain while taking Myfembree.

Good to know: The effects of Myfembree are reversible. In clinical trials, menstrual bleeding returned about 6 weeks after participants stopped taking Myfembree. This is because the medication helps with symptom relief. Myfembree doesn’t shrink or cure fibroids.

What are Myfembree’s side effects?

Taking Myfembree for fibroids was well-tolerated in studies. Commonly reported side effects include:

• Hot flashes

• Night sweats

• High blood pressure

• Irregular menstrual bleeding (spotting)

Less common side effects include lower sex drive (low libido) and hair loss. Contact your healthcare provider if you notice anything unusual after starting Myfembree.

Because high blood pressure is a common side effect of Myfembree, you shouldn’t take it if you have untreated or uncontrolled hypertension (chronic high blood pressure). Myfembree could raise your blood pressure to unsafe levels or cause your hypertension to worsen.

Rarely, the uterus can push certain types of fibroids out of your body, leading to severe bleeding and pain. Contact your provider if you notice severe bleeding or cramping while taking Myfembree.

Serious side effects of Myfembree: Is Myfembree safe?

Like all hormonal treatments, Myfembree does come with risks. It’s important to discuss these serious side effects and how they might affect you with your healthcare provider.

Bone loss

One of the biggest warnings is that Myfembree can cause bone loss. Because of this, it’s recommended to only take Myfembree for a total of 2 years. And you shouldn’t take it if you have osteoporosis. Your provider will likely monitor your bone density before starting and while taking Myfembree.

Blood clots

Another serious side effect of Myfembree is a higher risk of blood clots. All medications that contain a form of estrogen carry this risk. Thankfully, clinical trials for Myfembree suggest the risk is very low with this medication. You should avoid Myfembree if you have a history of blood clots or if you’re over 35 and you smoke.

Cancer risk

The estradiol in Myfembree can raise your risk for certain cancers, including breast cancer. Tell your provider if you have a personal or family history of any cancers, as this medication may not be the right choice for you. Be sure to discuss cancer warning signs to watch for with your provider and go to any recommended cancer screening appointments, such as mammograms, while taking Myfembree.

Mood changes

Myfembree can also cause mood and behavior changes in some people. Let your provider know if you have a history of mental health conditions, and contact them right away if you notice any sudden mood swings or thoughts of suicide while taking this medication.

Myfembree vs. Oriahnn

Oriahnn (elagolix / estradiol / norethindrone acetate) is another medication used to treat heavy menstrual bleeding due to fibroids. It’s very similar to Myfembree and was the first oral medication of its kind to be FDA-approved for this condition.

Both medications contain a GnRH antagonist, an estrogen, and a progestin. But, there are some notable things to keep in mind when comparing Myfembree and Oriahnn.

Oriahnn’s dosage

Oriahnn is a twice-daily oral capsule you can take with or without food for up to 2 years. The morning capsule has all three ingredients in it, but the evening dose only contains elagolix. This means you have to take the capsules in a certain order for them to work. Myfembree is simpler, as you only have to take one pill per day.

Oriahnn’s effectiveness

Oriahnn works well to help lessen menstrual bleeding. Between 68% and 77% of people who took Oriahnn in studies experienced lighter bleeding. And about 50% reported that their periods stopped while taking it.

Although there are no studies comparing the two, Myfembree had similar results to Oriahnn in its clinical trials. So, we can say they’re both effective options for treating heavy bleeding.

Oriahnn’s side effects

Oriahnn carries the same rare but serious warnings as Myfembree (including blood clots and bone loss) and was also well-tolerated by people in studies. The most common side effects included hot flashes, headaches, and unusual bleeding. You should expect a similar experience with both medications.

How to save on Myfembree

There are ways to save on Myfembree, which is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 per month for Myfembree using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Myfembree’s patient assistance program, which offers the medication free of cost.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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